scholarly journals Hospital staff registered nurses' perception of horizontal violence, peer relationships, and the quality and safety of patient care

Work ◽  
2015 ◽  
Vol 51 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Christina Purpora ◽  
Mary A. Blegen ◽  
Nancy A. Stotts
Keyword(s):  
Patient Care ◽  
Registered Nurses ◽  
Peer Relationships ◽  
Hospital Staff ◽  
Horizontal Violence ◽  
Quality And Safety

scholarly journals Horizontal Violence and the Quality and Safety of Patient Care: A Conceptual Model

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Christina Purpora ◽  
Mary A. Blegen
Keyword(s):  
Patient Care ◽  
Conceptual Model ◽  
Empirical Evidence ◽  
Horizontal Violence ◽  
Future Research ◽  
Quality And Safety ◽  
New Model ◽  
Research Education ◽  
Academic Settings

For many years, nurses in international clinical and academic settings have voiced concern about horizontal violence among nurses and its consequences. However, no known framework exists to guide research on the topic to explain these consequences. This paper presents a conceptual model that was developed from four theories to illustrate how the quality and safety of patient care could be affected by horizontal violence. Research is needed to validate the new model and to gather empirical evidence of the consequences of horizontal violence on which to base recommendations for future research, education, and practice.

scholarly journals P027: Nursing duties and accreditation standards and their impacts: the nursing perspective

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S86-S87
Author(s):  
P.K. Jaggi ◽  
R. Tomlinson ◽  
K. McLelland ◽  
W. Ma ◽  
C. Manson-McLeod ◽  
...  
Keyword(s):  
Patient Care ◽  
Registered Nurses ◽  
Online Survey ◽  
Care Delivery ◽  
Care Quality ◽  
Medication History ◽  
Quality Initiatives ◽  
Response Options ◽  
Accreditation Standards ◽  
Strongly Agree

Introduction: With ongoing medical advances and an increase in elderly and complex patients presenting to the Emergency Department (ED), there is a requirement for nurses to continue to gain new knowledge and skills to provide optimal patient care. Quality initiatives are frequently introduced with the goal of improving patient safety and the effectiveness of care delivery; some being provincial, while others are new requirements from Accreditation Canada. We sought the perspectives of emergency nurses regarding the importance of key ED processes and standards, and their impact on patient care and nurse efficiency. Methods: All Registered Nurses and Licensed Practical Nurses throughout the Edmonton Zone EDs were invited to complete an online survey consisting of 23 statements on nursing attitudes (10 on nursing duties) and beliefs (11 on the importance of Accreditation standards and their impacts; two that involved selecting the 5 most important nursing activities). The survey was constructed through an iterative approach. Response options included a 7-point Likert scale (‘very strongly disagree’ to ‘very strongly agree’). Median scores and interquartile ranges were determined for each survey statement. Results: A total of 433/1241 (34.9%) surveys were submitted. Respondents were predominantly Registered Nurses (91.4%), female (88.9%), and worked 0-5 years overall in the ED (43.7%). Overall, respondents were favourable (‘agree’ or ‘strongly agree’) towards the Accreditation Canada standards and other quality initiatives. They were, however, ‘neutral’ towards universal domestic violence screening, and whether there is a difference between Best Possible Medication History (BPMH) and med reconciliation. The top five nursing activities in terms of perceived importance were: vital sign documentation, recording of allergies, listening to patients’ concerns, hand hygiene, and obtaining a complete nursing history. Best Possible Medication History and the screening risk tools followed these. Conclusion: Despite their heavy workload, nurses strongly agreed on the importance of med reconciliation, falls risk, and skin care, but felt that improved documentation forms could support efficiency. Nursing perspective is valuable in informing future attempts to standardize, streamline, and simplify documentation, including the design and implementation of a provincial clinical information system.

scholarly journals Staff expectations for the implementation of an electronic health record system: A qualitative study using Normalisation Process Theory

2019 ◽  
Author(s):  
Carolyn Mccrorie ◽  
Jonathan Benn ◽  
Owen Johnson ◽  
Arabella Scantlebury
Keyword(s):  
Collective Action ◽  
Electronic Health Record ◽  
Patient Care ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Process Theory ◽  
Normalisation Process Theory ◽  
Successful Implementation ◽  
Health Record ◽  
Quality And Safety

Abstract Background Global evidence suggests a range of benefits for introducing electronic health record (EHR) systems to improve patient care. However, implementing EHR within healthcare organisations is complex and in the United Kingdom (UK), uptake has been slow. More research is needed to explore factors influencing successful implementation. This study explored staff expectations for change and outcome following procurement of a commercial EHR system by a large academic acute NHS hospital in the UK. Methods Qualitative interviews were conducted with 14 members of hospital staff who represented a variety of user groups across different specialities within the hospital. The four components of Normalisation Process Theory (Coherence, Cognitive participation, Collective action and Reflexive monitoring) provided a theoretical framework to interpret and report study findings. Results Health professionals had a common understanding for the rationale for EHR implementation (Coherence). There was variation in willingness to engage with and invest time into EHR (Cognitive participation) at an individual, professional and organisational level. Collective action (whether staff feel able to use the EHR) was influenced by context and perceived user-involvement in EHR design and planning of the implementation strategy. When appraising EHR (Reflexive monitoring), staff anticipated short and long-term benefits. Staff perceived that quality and safety of patient care would be improved with EHR implementation, but that these benefits may not be immediate. Some staff perceived that use of the system may negatively impact patient care. The findings indicate that preparedness for EHR use could mitigate perceived threats to the quality and safety of care. Conclusions Health professionals looked forward to reaping the benefits from EHR use. Variations in level of engagement suggest early components of the implementation strategy were effective, and that more work was needed to involve users in preparing them for use. A clearer understanding as to how staff groups and services differentially interact with the EHR as they go about their daily work was required. The findings may inform other hospitals and healthcare systems on actions that can be taken prior to EHR implementation to reduce concerns for quality and safety of patient care and improve the chance of successful implementation.

P035: Development of a province-wide audit program for return visits to the emergency department

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S89-S90
Author(s):  
L.B. Chartier ◽  
O. Ostrow ◽  
I. Yuen ◽  
S. Kutty ◽  
B. Davis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Care ◽  
Quality Care ◽  
Improve Patient Care ◽  
Lessons Learned ◽  
Quality And Safety ◽  
Term Care ◽  
Clinical Observations ◽  
Quality Program ◽  
Physician Leaders

Introduction: Routine auditing of charts of patients with an emergency department (ED) return visit (RV) resulting in hospital admission can uncover quality and safety gaps in care. This feedback can be helpful to clinicians, administrators, and leaders working to improve clinical outcomes, increase patient satisfaction, and promote high-value care. Health Quality Ontario (HQO) has been tasked by Ontario’s Ministry of Health and Long-Term Care (MOHLTC) to manage the newly created ED RV Quality Program (RVQP), which mandates EDs participating in the Pay-for-Results (P4R) program to audit a minimum of 25-50 RVs/year. The goal of the first-ever ED-specific province-wide Quality Improvement (QI) initiative of this kind is to promote a culture of QI that will lead to improved patient care. Methods: Participating hospitals receive quarterly confidential reports from Access to Care (ATC) that show their and other hospitals’ rates of RVs, as well as identifying information for patients meeting RV inclusion criteria at their ED (within 72 hrs of index visit, or within 7 days with specific diagnoses). HQO has partnered with QI experts and ED physician-leaders to develop various guidance materials. These materials have been disseminated through various media. Hospitals are conducting audits to identify underlying quality issues, take steps to address the underlying causes, and submit reports to HQO. A taskforce will then analyze clinical observations, summarize key findings and lessons learned, and share improvements at a provincial level through an annual report. Results: Since its launch in April 2016, 73 P4R and 16 voluntarily enrolled non-P4R hospitals (which collectively receive approximately 90% of ED visits in the province) are participating in the RVQP. ED leaders have engaged their hospital’s leadership to leverage interest and resources to improve patient care in the ED. To date, hospitals have conducted thousands of audits and have identified quality and safety gaps to address, which will be analyzed in February 2017 for reporting shortly thereafter. These will inform QI endeavours locally and provincially, and be the largest source of such data ever created in Ontario. Conclusion: The ED RVQP aims to create a culture of continuous QI in the Ontario health care system, which provides care to over 13.8 million people. Other jurisdictions can replicate this model to promote high-quality care.

Retaining Master and DNP Registered Nurses in Direct Patient Care: Utilizing Nurses to the Fullest Extent of Their Education

Nurse Leader ◽  
2015 ◽  
Vol 13 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Pauline J. Abraham ◽  
La Donna D. Mc Gohan ◽  
Dale M. Pfrimmer
Keyword(s):  
Patient Care ◽  
Registered Nurses ◽  
Direct Patient Care

So You Want to Change Practice: Recognizing Practice Issues and Channeling Those Ideas

2012 ◽  
Vol 32 (2) ◽  
pp. 55-64 ◽  
Author(s):  
Paula Lusardi
Keyword(s):  
Patient Care ◽  
Nursing Practice ◽  
Clinical Problem ◽  
Care Quality ◽  
Staff Nurses ◽  
Practice Change ◽  
Quality And Safety ◽  
New Knowledge ◽  
Patient Care Quality

Applying the best evidence to support nursing practice and generating new knowledge for use in practice are the hallmarks of excellence and allow practitioners to meet patient care quality and safety priorities. Although identifying a patient care problem comes easily to staff nurses, the process of clarifying the problem and channeling those ideas through to a practice change can be daunting for bedside nurses. This article provides guidance to staff nurses who want to identify a clinical problem and change practice.

scholarly journals High Reliability Care: At the Intersection of Policy and Practice

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
United States ◽  
Health Care ◽  
Patient Care ◽  
Health Care Policy ◽  
High Reliability ◽  
Local Level ◽  
The United States ◽  
Joint Commission ◽  
Local Health ◽  
Quality And Safety

Health care organizations in the United States struggle to maintain safety and provide quality patient care. In a complex policy environment, the Joint Commission has directed its efforts toward helping health systems achieve high reliability health care. Heath care organizations, facing both accreditation imperatives and political challenges, are mired in the uncertainty of resource availability. The challenges of high reliability in a high stakes industry elude even the most seasoned CEOs and administrators. In particular, it is essential at this time is to pinpoint how public health policy, when coupled with development of high reliability culture, informs implementation of quality and safety at the local level and advances Joint Commission directives related to high reliability care. This theoretically focused paper explores the phenomena of quality and safety from the vantage of two differing lenses, practice and policy. The theoretical analysis of high reliability health care (policy, organizational structure, and actors) contributes to further understanding the challenges facing high reliability patient care implementation throughout hospital systems in the United States. Discussion highlights appropriateness of model fit, whether a top down approach to patient care is realistic, and possible challenges of a centralized policy in an inherently decentralized industry environment. Conclusions reinforce the need for local health care systems and administrators to adopt and adapt the Joint Commission’s high reliability model to their system to correct industry failures.

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